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Impact of donor obesity and donation after cardiac death on outcomes after kidney transplantation
Author(s) -
Ortiz Jorge,
Gregg Austin,
Wen Xuerong,
Karipineni Farah,
Kayler Liise K.
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2012.01649.x
Subject(s) - medicine , body mass index , hazard ratio , odds ratio , kidney transplantation , transplantation , obesity , surgery , confidence interval
The effect of donor body mass index ( BMI ) and donor type on kidney transplant outcomes has not been well studied. S cientific R egistry of T ransplant R ecipients data on recipients of deceased‐donor kidneys between 1997 and 2010 were reviewed. Donors were categorized by DCD status ( DCD , 6932; non‐ DCD , 90,158) and BMI groups at 5 kg/m 2 increments: 18.5–24.9, 25–29.9, 30–34.9, 35–39.9, 40–44.9, and ≥ 45 kg/m 2 . The primary outcome, death‐censored graft survival ( DCGS ), was adjusted for donor, recipient, and transplant characteristics. Among recipients of non‐ DCD kidneys, donor BMI was not associated with DCGS . Among DCD recipients, donor BMI was not associated with DCGS for donor BMI categories <45 kg/m 2 ; however, donor BMI ≥45 kg/m 2 was independently associated with DCGS compared to BMI of 20–24.9 kg/m 2 (adjusted hazard ratio, 1.84; 95% CI , 1.23, 2.74). The adjusted odds of delayed graft function ( DGF ) was greater for each level of BMI above reference for both DCD and non‐ DCD groups. There was no association of donor BMI with one‐yr acute rejection for either type of donor. Although BMI is associated with DGF , long‐term graft survival is not affected except in the combination of DCD with extreme donor BMI ≥45.